Contributed by David L. Bastin (2012) [David Lee Bastin studies social work as a graduate student at Tennessee State University. David’s interest in social work stems from his work as a therapist for the Tennessee state mental institution. David plans to continue working with those suffering from serious mental conditions such as schizophrenia and psychotic disorders. Follow David on Twitter @DAVIDBASTIN2]
Conduct Disorder is the most frequently diagnosed mental disorder in children and adolescents.
At least 6% of children under the age of eighteen have been diagnosed with Conduct Disorder.
The disorder has historically affected more boys than girls (American Academy of Child & Adolescent Psychiatry, 2010). Conduct Disorder is described by the DSM IV (1994), as a repetitious behavior which violates the norms or rules of a particular society. These behaviors are generally grouped into four categories.
- Aggressive (physical harm to other people and/or animals).
- Non-aggressive (property damage).
- Deceitfulness ( which may involve theft).
- Continuous behavior which violates serious rules.
A competent social worker has the knowledge and insight to perform a detailed assessment of a client and the family including medical history, cultural aspects, and social environments. The complex nature of Conduct Disorder and the seriousness of the problems associated with it require an extensive look at the clinical picture.
Contributors to Conduct Disorder
Heredity, neurology, and family dynamics have been cited as contributors to Conduct Disorder. These contributors suggest a role for social workers, health professionals, and community supports. When a child presents these behaviors at an earlier age, it is more likely that the child will develop Antisocial Personality Disorder as an adult.
Symptoms associated with Conduct Disorder have been linked to genetic elements involving hereditary plausibility evidenced by a specific gene, according to the journal article “Genome-Wide Association Study of Conduct Disorder Symptomology” published in 2011.
Brain structure and a reduced ‘gray-matter’ in the regions which process socio-emotional stimuli correlate with Conduct Disorder, as well (Fairchild, Passamonti, Hurford, Hagan, von dem Hagen, van Goozen, Goodyer & Calder, 2011). However, many believe family dynamics, chronic stress, and poor nutrition contributes to the release of these genetic forces which bring about Conduct Disorder.
Family dynamics and home life may be a contributing factor toward Conduct Disorder and the associated symptoms. Studies examining the relationship between ‘home-chaos’ and Conduct Disorder show a positive correlation (Shamama-tus-Sabah & Gilina, 2011). However, a study of socio-economically disadvantaged families had mixed results, suggesting that poverty alone does not produce children with Conduct Disorder. Poverty, though, does affect the child’s overall well-being (Flouri & Kallis, 2011). Therefore, it is important to consider all aspects of adolescent psychopathology.
Intervening with Conduct Disorder
Evidence-based interventions are one approach for derailing Conduct Disorder. Short-term goals need to be established so they can evolve into long-term goals, as Conduct Disorder can be a difficult and long process. However, early intervention is a key to success. The social worker/family must be aware of the symptoms of Conduct Disorder and implement possible solutions.
Short Term Goals
Ask the child to…
- Admit to intentionally participating in the behavior (Reinforce honesty and ownership).
- Verbalize and visualize the consequences (Reinforce reasoning and critical thinking).
- Accept responsibility for actions (Reinforce consistency and responsible behavior).
- Manage anger (Reinforce self-correction and self-reflection).
Long Term Goals
- Strengthen family relationships. Assess the quality of relationships and research family history.
- Model sustainable behavior. Find a role model for the child or adolescent, such as a strong family member or a mentor.
- Educate. Educate the parent(s) and educate the client. Translate the client’s energy into behavioral strengths. For example, communicate that anger can be used as motivation. Theft may indicate mechanical skills.
- Empathize. Build empathy in the child. Engage the child to express personal feelings and articulate the feelings of others.
- Change the Environment. Influence the child’s environment through family discussions, meal time, and bedtime routines. Respite, recreation, and camps are other ways to break the cycle of the environment.
It is important to focus on the child’s strengths and positive qualities as motivational techniques which may help to change the behavior and redirect the trajectory of the child (Powell, Lochman, Jacson, Young & Yaros, 2009).
The child may be a gifted author or have other abilities in music, art, or athletics. These abilities can be used to guide the child’s disruptive behavior toward other interests. Certain institutions may help the child, but funding for proper care is rare for those who lack resources. Conduct Disorder is a societal problem and generally will take family, mentors, professionals, funding, and education, in order to generate legitimate solutions.
- American Academy of Child & Adolescent Psychiatry. (2010). Your child: Conduct disorders.
- Dick, D.M.; Aliev, F.F.; Edwards, A.A.; Agrawal, A.A.; Lynsky, M.M.; Lin, P.P.; Bierut, L.L. (2011).
Genome-wide association study of conduct disorder symptomology. Molecular Psychology, 16(8), pp. 800-808.
- DSM-IV. (1994). Conduct disorder 312.8: Disorders usually first diagnosed in infancy, childhood, or adolescents, pp. 85-90.
- Fairchild, G.; Passamonti, L.; Huford, C.; von dem Hagen, E.; van Goozen, S.; Goodyer, I.; Calder, A. (2011). Brain structure abnormalities in early-onset and adolescent-onset conduct disorder. The American Journal of Psychiatry, Vol 168(6), pp.624-633.
- Flouri, E.; Kallis, C. (2011). Adverse life events and mental health in middle adolescence. Journal of Adolescence, Vol 34(2), pp. 371-377.
- Powell, N.; Lochman, J.; Jackson, M.; Young, L., Yaros, A. (2009). Assessment of conduct problems. Springer Science + Business Media, pp. 185-207.
- Shamama-tus-Sabah, S.; Gillani, N. (2011). Conduct problems, social skills, and home chaos in school children: A correlation study. Journal of Psychological Research, Vol 26(2), pp. 201-215.